CMS Formulary

Displaying 72451-72460 of 1611142 results.
ID: 72451
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72452
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 72453
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72454
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 72455
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72456
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 72457
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 311376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 72458
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 864761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 72459
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 72460
Formulary ID: 00021026
Formulary Version: 14
Contract Year: 2021
RXCUI: 315187
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0